RA Messages for April 24, 2007

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ATTENTION PROVIDERS

EFFECTIVE 7-2-2007, IN ACCORDANCE WITH A RECENT DHH DIRECTIVE, UNISYS WILL NO LONGER ACCEPT COPIES OF STANDARD CLAIM FORMS, THE REGULATIONS DO NOT ALLOW THE COPYING OF HARDCOPY CLAIM FORMS. THESE INCLUDE THE UB-92, UB-04, CMS 1500 (12-90), CMS 1500 (08-05), ADA, AND THE NCPDP UNIVERSAL CLAIM FORM. ANY HARD COPY CLAIMS SUBMITTED TO UNISYS FOR PROCESSING MUST BE AN ORIGINAL, STANDARD CLAIM FORM AND MUST MEET THE LICENSURE/ COPYRIGHT REQUIREMENTS OF THE PARTICULAR ORGANIZATION THAT REGULATES THAT CLAIM FORM. THIS INCLUDES ORIGINAL SUBMISSIONS, RE-SUBMISSIONS OF PREVIOUS CLAIMS, AND CLAIM ADJUSTMENTS/VOIDS.

WITH THE IMPLEMENTATION OF THIS REQUIREMENT, PROVIDERS THAT ARE ROUTINELY BILLING ALL CLAIMS HARD COPY MAY WANT TO CONSIDER TRANSITIONING TO ELECTRONIC CLAIMS SUBMISSION. QUESTIONS CONCERNING EDI BILLING MAY BE DIRECTED TO THE UNISYS EDI DEPARTMENT AT 225/216-6000, OPTION 2. A COMPLETE LISTING OF APPROVED EDI VENDORS IS AVAILABLE ON THE LA MEDICAID WEB SITE, WWW.LAMEDICAID.COM, LINK HIPAA INFORMATION CENTER/LINK VBC LIST. PLEASE CONTACT THE VENDORS FOR SPECIFIC INFORMATION ON THEIR SERVICES AS A WIDE RANGE OF PACKAGES/FEES ARE AVAILABLE.

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ATTENTION COMMUNITYCARE PROVIDERS - IMMUNIZATION PAY-FOR-PERFORMANCE

IMMUNIZATION PAY-FOR-PERFORMANCE (P4P) PAYMENTS FOR JULY-SEPTEMBER 2006 HAVE BEEN ISSUED TO ELIGIBLE PCPS WHO REGISTERED FOR P4P PRIOR TO MARCH 12, 2007. IMPORTANT INFORMATION ON P4P PAYMENTS INCLUDING INSTRUCTIONS TO ACCESS THE P4P-SPECIFIC *PROVIDER REMITTANCE ADVICE STATEMENT* CAN BE FOUND AT WWW.LAMEDICAID.COM UNDER THE COMMUNITYCARE IMMUNIZATION PAY- FOR-PERFORMANCE (P4P) INITIATIVE LINK.

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ATTENTION PROVIDERS - FAMILY PLANNING WAIVER RECIPIENT INFORMATION

THE ANNUAL EPSDT RECIPIENT NOTICE WAS RECENTLY MAILED TO MEDICAID RECIPIENT HOUSEHOLDS WITH CHILDREN UNDER 21. THIS NOTICE WAS MAILED TO FAMILY PLANNING WAIVER RECIPIENTS IN ERROR. A RETRACTION NOTICE HAS BEEN MAILED TO THOSE FAMILY PLANNING WAIVER RECIPIENTS. PLEASE BE AWARE OF THIS ERROR, AND IN ORDER TO PREVENT PROVIDING NON-COVERED SERVICES TO A FPW RECIPIENT WHO MAY PRESENT THIS NOTICE WHEN SEEKING SERVICES, BE SURE TO CHECK RECIPIENT ELIGIBILITY TO ENSURE THAT THE RECIPIENT IS ELIGIBLE FOR EPSDT SERVICES.

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ATTENTION PROVIDERS - PROPOSED CLASS ACTION SETTLEMENT

A PARTIAL SETTLEMENT HAS BEEN REACHED IN A LAWSUIT INVOLVING FOCUS HEALTHCARE MANAGEMENT AND OTHER NON-SETTLING DEFENDANTS FOR POSSIBLE FAILURE TO PROVIDE APPROPRIATE NOTICE BEFORE PPO DISCOUNTS WERE APPLIED TO PROVIDERS' BILLS SUBMITTED UNDER THE LOUISIANA WORKERS' COMPENSATION LAW. INFORMATION IS AVAILABLE BY CALLING 1-800-469-0247 OR GOING TO THE WEBSITE, WWW.FOCUSSETTLEMENT.COM.

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ATTENTION PROVIDERS

THE 2007 HCPCS CODES HAVE BEEN LOADED TO OUR FILES AND MAY BE SUBMITTED FOR DATES OF SERVICE JANUARY 1, 2007 FORWARD. LOOK FOR THE UPDATED 2007 FEE SCHEDULE ON THE LOUISIANA MEDICAID WEBSITE, WWW.LAMEDICAID.COM, IN

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ATTENTION REHABILITATION PROVIDERS

WE EXPERIENCED INTERNAL CODING ERRORS WITH REGARDS TO SOME REHABILITATION HCPCS BACK IN 2005. ALTHOUGH THE PROGRAMMING WAS CORRECTED, BOTH DENIED AND OVERPAID CLAIMS WERE NOT RECYCLED. CLAIMS WHICH WERE INADVERTENTLY OVERPAID HAVE BEEN ADJUSTED ON THE REMITTANCE ADVICE DATED APRIL 10, 2007. CLAIMS WHICH WERE INAPPROPRIATELY DENIED HAVE BEEN RECYCLED ON REMITTANCE ADVICES DATED APRIL 10 AND 17, 2007.

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ATTENTION PROVIDERS - NATIONAL PROVIDER IDENTIFIER

DHH HAS LAUNCHED A NEW NPI WEB REGISTRATION SITE FOR PROVIDERS TO REGISTER THEIR NPI WITH LOUISIANA MEDICAID. CMS WILL REQUIRE ALL HIPAA STANDARD TRANSACTIONS, INCLUDING MEVS ELIGIBILITY INQUIRY AND CLAIMS STATUS INQUIRY TO BE SUBMITTED USING THE NPI NUMBER BEGINNING 23-MAY-07. THE NEW NPI APPLICATION IS ACCESSIBLE FROM THE LIST OF APPLICATIONS IN THE SECURED PROVIDER AREA OF THE WWW.LAMEDICAID.COM WEB SITE. FIND THIS AND MORE ON THE NPI INFORMATION PAGE ACCESSIBLE FROM WWW.LAMEDICAID.COM>
HIPAA INFORMATION CENTER>NATIONAL PROVIDER IDENTIFIER (NPI).